Improving prison health in Trentino (Italy)
The United Nations Basic Principles for the Treatment of Prisoners state that “prisoners shall have access to the health services available in the country without discrimination on the grounds of their legal situation”. In Italy this principle has been implemented by means of a national law (the Decreto del Presidente del Consiglio dei Ministri of 1 April 2008) that assigns responsibility for prisoners’ health directly to the National Health Service (removing it from the Ministry of Justice), thereby establishing the equal treatment of citizens within and outside of prison walls.
Since local health units are in charge of prison health in Trentino, high-quality medical assistance is guaranteed in local prisons. However, prisoners suffer a disproportionate burden of health problems and their health needs – particularly in terms of their opportunities to adopt healthy lifestyles inside prison facilities – are often neglected.
In May 2016, in order to monitor health status and to inform and stimulate health promotion efforts, a cross-sectional survey was conducted on prison health, with face-to-face interviews carried out with a representative sample of 250 inmates of the local prison, using a standardized questionnaire adopted from the Italian behavioural risk factor surveillance system (Progressi delle Aziende Sanitarie per la Salute in Italia (PASSI)).
Not surprisingly, one of the main results of the survey is the relatively high proportion of symptoms of depression (42%), measured by patient health questionnaire PHQ-9, particularly among the younger age groups, non-native prisoners and those with financial problems or with problems maintaining regular contact with friends and family. Other important findings include the high prevalence of smokers (72%), non-smokers exposed to second-hand smoke in their cells (44%), those with a sedentary lifestyle (40%), and those with low fruit and vegetable consumption (13% of the recommended “five-a-day” consumed). Furthermore, 65% of prisoners declared heavy alcohol consumption prior to incarceration.
Results were disseminated among stakeholders and it was agreed that a health promotion action plan should be established, based on the study’s findings.